Weekly musings, 3/10/18: C-sections and movement

Approximately 31.9% of births in the US will be performed via Cesarean section. The two incision techniques most frequently used during a C-section require slicing through an abdominal area innervated by two nerves, one of which, the ileo-inguinal, contains sensory fibers to the groin and motor fibers to the large abdominal muscles.* The second nerve, the ileo-hypogastric, pierces through the transverse abdominis and passes through the abdominal obliques. During surgery, the abdominal fascia is cut and the muscles are pulled apart by the surgeon.

Over the years, I have trained several women who had C-sections performed on them during the birth of their children. Not only is surgery potentially traumatic (the majority of my clients who had C-sections spent time in labor, only to be told vaginal delivery wasn’t going to be an option), but in my experience, physical therapy is rarely prescribed after the 8 week recovery period. 

When women post C-section return to exercise, again, in my experience, there is generally a disconnect with the sensation of the abdominal muscles. When you consider the incision, it makes sense. A sensory rich area has been cut, and muscles have been stretched (not of their own volition). It seems logical what the individual experiences and feels in the abdominal region is different after surgery than what she experienced before C-section. It also seems logical that for some individuals post c-section, spending time becoming re-acquainted with what it feels like when the deep core muscles contract to provide support may be beneficial for proprioceptive feedback and an overall sense of strength and internal security.

Exercise should be encouraged for new mothers for a variety of reasons; however, recovery from surgery and all that goes along with it makes exercise post C-section a little bit trickier. If you have a C-section, don’t be afraid to ask for physical therapy, and when you do return to exercise, make sure you listen to your body. If you feel disconnected from your abdominal region or like you aren't supported in your center, find someone that can help. Taking a little bit of time to feel whole again can go a long way to ensuring a life filled with movement.

*https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4315586/